TITLE:
Metastasis of Upper Gingival Squamous Cell Carcinoma to Buccinator Lymph Node: Case Report and Review of the Literature
AUTHORS:
Norosoa Randriamaroson, Hannae Bakkali, Noureddine Benjaafar
KEYWORDS:
Buccinator Lymph Nodes, Facial Lymph Nodes, Oral Cancer, Squamous Cell Carcinoma, Upper Gingiva
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.14 No.6,
October
22,
2025
ABSTRACT: Background: Metastasis to the lymph nodes is the most prognostic factor in patients with oral cancer. The antegrade lymphatic flow in patients with normal anatomy and physiology makes metastasis of upper gingival cancer to buccinator lymph nodes unlikely and uncommon. Case Presentation: A 50-year-old woman presented with a locally advanced squamous cell carcinoma 87 × 28 mm on her upper left anterior region of gingiva, along with metastatic buccinator nodes in the left and right respectively 26 × 23 mm and 24 × 22 mm, cervical lymph nodes and retropharyngeal lymph node without distant metastasis. Metastatic buccinator lymph nodes were independent of the primary tumor and round in shape. She underwent a multidisciplinary treatment by induction chemotherapy consisting of Docetaxel-Cispaltin-5 Fluoro Uracile. Two weeks after, she was treated with adjuvant radiotherapy (69.96Gy/33 fractions) with concurrent Cispaltin chemotherapy 40 mg/m2 per week for five weeks. After two months, she returned with a scale four of performance status and died five days later. Conclusion: Metastasis to buccinator lymph nodes from upper gingival cancer is rare, and indicates a poor prognosis when present. We suggest that the possibility of metastasis to the buccinator node should be considered thoroughly in planning treatment for locally advanced oral cancer.